The aim of this project is to carry out a comprehensive research program of cerebrovascular disease. The proposed investigations include basic science investigations on effects of ischemia and hypoxia on cerebral metabolism or on the role neurotransmitter function in relation to hypertension and cerebral ischemia. The clinical studies include use of ultransonic techniques in diagnosis of carotid occlusive disease and the pathogenetic mechanisms for hypoxic-ischemic-leukoencephalopathy. Our ongoing studies of the geographic differences in stroke mortality in North Carolina will be continued along with the use of a computerized information system for the study of transient cerebral ischemia (TIA). Thus, this project will include basic science research as well as clinical and epidemiologic investigations of stroke.